jennrn52

Now THAT was irresponsible of your preceptor. No matter what the procedure is, it should be see one, do one, teach one. If you had never done it then absolutely she should not have sent you in alone to do it. Or if she was right there she better have had a pair of sterile gloves so she could help when needed. Some female caths are extremely difficult, especially if there is any post op swelling. And to anyone reading this who is a new nurse, you absolutely do not perform a procedure you've never done without supervision. If your preceptor will not go in with you, you find someone who will. On on subject of this thread, the logic of the male and female stuff is rediculous. So it's not ok for a man to cath a female because its penetration? But it's okay for a female to do it? What if the female nurse is a lesbian? What if it was a male patient and the male nurse was gay? Does that make a difference? It shouldnt. In the er we would do our own patients. If the patient specifically requested a female or vise versa, we would trade tasks. I will do the cath if you give these meds or start this line, etc. but we also did that for any task if we were unable to do like if we couldn't get the line started. The only time there was two in the room was if there was assistance needed to hold a leg or something.

Hey, I'm sorry you failed. But listen, don't beat yourself up over it. It was one test. And these tests are crazy hard. Even when you're right, it's not the most correct answer. I did okay through my first two semesters, then my third semester first test I thought I knew the material and made a D. I talked to the instructor (which was very frightening, everyone was scared of her!) and she sat with me and would ask me to explain the answers, etc. the biggest piece of advice she gave me was "when you study the material, think of how you would explain it to the patient. Because you will be the one they ask questions to, not the doctor." And then she added if I failed the next test I had to come explain to her why I failed it. Aaah!!! I made an A on the next test (first time ever in the nursing program!) and did so well I could have made a 50 on the final and still pass the class. what I started doing was I would look at the material and rephrase it into basic layman terms. So simple my mom with no medical background was able to understand it when I talked about it. Once I got that down I then would start looking at the medical part (expected lab results, tests to diagnose, etc) and would think of why the outcome would be that way or why the doctor would order such and such. Once I understood it for one disease, it would actually start clicking better for others because it would start carrying over. I hope this helps with you on your next test and future tests. And i I know it can be devastating but don't give up. I went to school with a girl who failed our last semester, retook the class, failed again and was kicked out of the program (you could only fail twice). She went to Lpn school, passed, and a few years later went back and completed her RN. She is now an awesome NICU nurse.

I love the autonomy and my schedule being so flexible. I'm full time, I generally start my day around nine and am done by 4-430, but stick around my area in case something pops up. No big deal because I live ten minutes down the road, but if I let the babysitter go home and a patient calls I'm stuck. But if my son has something at school, I can take an hour off and go. I love spending time with the patients, and their pets! One lady I had had this cat who would never come to anyone except me. Every visit I'd pick her up and love on her and she would just purr like crazy, it amazes my patient because she couldn't even pick her up. this job definitely isn't for everyone, you have to be confident in your skills and knowledge, especially because some of these patients know more about their diseases than you do! When I get those patients I talk with them about their experiences and get tips and ideas for other patients, it's great!

I kind of forgot about this thread and found it again tonight. I came across my first post and laughed when I realized it was me!! I'm still doing home health, same company, same supervisor, but things are a lot different now. We get along great, I think she had to get used to me and same for me. My LPNs I work with are still here but only work weekends. I have another RN who just started PRN who used to work for us so hopefully that will help. My "partner" (the other full timer on my team) was off today for a funeral, so I took some of her patients. My original schedule was all routine visits with a couple discharges. BUT, two patients went to hospice and a third is doing the hyperbaric chamber for his wound. Took them off the schedule. That left me with a total of eight visits. My scheduler asks if I can do a start in my partners area, about 30 minutes out of my normal area. Sure! Why not! So! On to my day! I got to my first patient about 0900. patient 1- has surgical wound to hip, do the wound care. Excited because his dr was okay with me trying silver alginate and I saw today it's really working! He's had the wound for a long time, was in rehab since 2014 and had five surgeries on his hip in that time. They were just cleaning and covering it in rehab. His drainage is waaaaay decreased and the wounds almost closed! Woot! drive ten minutes to next one Patient 2- very very hard of hearing, was discharged from another agency for multiple missed visits. Because she can't hear for crap when they knocked. We took over, it's my first visit since my start Wednesday. Knock knock.....after five minutes of knocking and ringing the bell I gave up. Called the d-i-l, said I would try again in the afternoon. drive 30 minutes to next one patient 3- the hard one of my partner. Has an hour long wound care regimen to both legs, skin thickening, legs very large. His O2 sat was 71% on room air, slapped his oxygen on. He took a few deep breaths, denied any sob, asymptomatic. Recheck now 95%. Yay! Moving on. drive ten minutes to next one patient 4- another of my partners wound cares. Actually takes a lot less time now because they took off the wound vac. She said it wasn't healing and they are going to try the hyperbaric chamber. She will probably be a discaharge soon. drive 30 minutes to next one patient 5- my own patient, agency discharge. I was going to try and extend her visits, but couldn't get the order. She had heart surgery, extensive cardiac history. Educated again on cardiac complications, weight monitoring, meds and bowel monitoring since she's had some constipation. Gave her my number and told her she could call my cell with questions. I don't normally do that but I've had her before and just love her to pieces, and she doesn't follow up until Wednesday. drive 30 minutes to next one patient 6- the added on start. Tried calling, no answer, so I do a drive by. He actually is in an alf, but one I've never been to. Spend a few minutes talking to the LPN there, she then realizes he is already with another company. Sweet!! Less paperwork! Run in by the office since I'm five minutes away, give report (finally) on a couple starts I did yesterday and Wednesday (we normally call same day or the next morning but the supervisors and myself have been crazy busy). drive 30 minutes to next one patient 7- lady I had done a nursing dc on last week because her wound had been healed for 2 1/2 weeks. Went to doctor Wednesday and .....it reopened.... So this was my second revisit after her eval (she was still with PT). Wound is healing well, slap a dressing on. Spend a few extra minutes talking about my kids and their shenanigans, thinking I only had two people left and its 3:45. Drive ten minutes to next one wrong!! Forgot and patient 2 not answering earlier! Ugh! Went back and she was actually there. Reviewed her meds, told her we would be putting the DIL in touch with an agency to provide sitter care. She has dementia and DIL lives an hour away and can only get there on Sunday's. Very agreeable and was so relieved I came back instead of ditching her. Scheduled her next visit and took off. drive ten minutes to next one patient 8- daily insulin, very unpleasant, bipolar and dementia. Still pretty with the program but is in a locked unit because she would leave the alf and not tell anyone. Today she was in a good mood because Elvis came and performed, yay! My BP cuff sprung a leak as I was doing her vitals, boo! drive 20 minutes to next one patient 9- nursing discharge for my partner. Educated her on hypoxia and chf symptoms, still with PT and OT. therapy arrived while I was there, which was great because I could use her BP cuff! Finished the visit and took off for home, about 30 minutes away. finished the day at 530, but I still have a lot of charting to do. I probably could have rearranged my prescheduled patients to make the drive time less, but I hate doing that so I sucked it up today. How was your day??

Wow just realized how long that was, so sorry! :)

I love this thread! I got started in home health April of last year per diem, then in September went full time. The office was 1 1/2 hours away from my house but I had a "hook-up" with getting an interview because I knew one of the supervisors (PCC). When I went full time I went from per visit to salary with "compensation." That is, I get a set salary, plus car allowance and cell phone allowance. I am required to get 35 points a week, and anything over that I get the per diem visit rate for each point over 35. Boy did I blow up the bank on that one! I was averaging 45-50 points a week. However the strain on my car, time and family was too much, and a few months ago discovered that another branch of the company had a full time position open for a section of the county I lived in that was 15 minutes away from my house. Woot! So I transferred. Big mistake. Can't stand the supervisor, she is an IDIOT and can't ever get things done in a timely manner. Not really a fan of my fellow field nurses, the two I work with in my area are per diem LPNs and they used to get tons of visits but since me and another FT nurse started they get squat now and they are very vocal about it. Anyway I've been reading other posts and I saw one that she covers 27 counties??????? Whaaaa???? Not sure how everyone else does it but my company generally has a branch in whatever county they are covering here in Florida. The exception is my current branch. Their office wasn't getting alot of visits so they took the southern end of the county just north to them (my current territory) because the area is SO BIG. We are paid by Medicare so I see nothing but little old people and the younger ones on it for disability. Just a little back story. On to my day! I had to move some patients off tomorrow because they are making me take the day off because I'm on call this weekend. Yes, MAKING me. I would rather work, it would just make my life easier. I've had to give away visits because I've had almost 14 regular visits every day. So today I originally had I believe 10 regular visits, no admissions (thank goodness). Making my phone calls last night and one of my pts had an MD appointment today to get the wound below her stoma looked at. So I told her we would skip the weekly check up this week (she does her own wound care, long story, unable to d/c due to open wound and the surgeon doesn't know what to do so we help determine WC). Down to nine visits. Doable! Had to get to the office early this morning to drop off paperwork (yes we are still on paper in this day and age!) and of course get held up by my supervisor yammering *yawn*. Finally get out of the office (which BTW is 30 minutes from my area I cover) around 900. Which is great since I was due to be at my first patient at 900. Show up at 930, he isn't there. Greeeeat, will try again later. On to #2. He has a wound on his foot that everyone thinks is a diabetic ulcer....except he's not diabetic.....anyway he goes to the wound care center weekly, they send new orders, yadda yadda. They decided to totally change up his wound care, using something I had to Google. It's called Tritec by Milliken. Interesting. Will have to see how this goes. He then informs me that even though his orders from the center say F/U in 1 week that would be Memorial Day, so it's 2 weeks. Will have to call and clarify since our orders will end next Monday. Pretty lengthy wound care, but shuffle through then it's off to my next one who is about 20 minutes away. #3 is the sweetest little man. He's a quad x 7 years since neck surgery gone awry. He gets weekly foley changes and currently has a massive heat rash to back and booty and has a wound on his arm he got at the hospital that is healing up nicely. He lives with his little old wife who takes care of him and has hired help bathe him 4x week. I change the bandage, his wife tells me she had to change the foley sunday because he had so much sediment it clogged the cather (again). Suggested he drink more fluids and start running on the treadmill to decrease the sediment. That got a laugh out of both of them. Off to the next, another 20 minute drive back to the area I was at this morning. #4 He had back surgery, they left a sponge in, now he has a huge wound on his back. Daily wound care, luckily his cute little wife can do it sometimes too. Whip through that visit, smell that their son got a pizza for lunch and hear my stomach growl. Realize it's now 1200. Off to the next patient! #5 zip over to him right quick about 5-10 minutes down the road. He also has a chronic ulcer on his foot that IS complicated by Diabetes. And he's mildly overweight. And he smokes. He has a cute little doggy though. He goes to the same clinic as #2, same doctor, ALMOST the same wound care. He also tells me his next appointment is in two weeks, and his order says F/U 5/29. Hmm.....something is fishy.....will have to call and clarify this....but it's 1230 so they are at lunch......mmmmm food..... Stop at McD's and eat since the Big Mac is on sale for $2 :) Head over to #5, little old man with a skin cancer removal from his head we have been treating for a few months. I almost had the joker healed 3 weeks ago and the flipping dermatologist thought it would be a great idea to put silver nitrate over the WHOLE THING. So I feel like we are back at square one again. Play with their collie for a few minutes, I think they want me to take him, they keep commenting how my little boys would love him. Lemme get out of here before they ask! Head over to an ALF memory care to see #6, 7, and 8. They all live in the same unit (how convenient!) and two of them are husband and wife (how cute! they're demented together!) Do the husbands wound care (this is a joke, flush his toe with saline, apply TAO, and literally put a band aid on it. but the alf can't do it.) Go to do the wife's skin tears and man! Is she crotchety today or what!!! Come to find out from the staff she went to the doctor today. So I don't have to see her after all. Which was fine by be because she was all mad because she thought her husband was flirting with the cup of popcorn in front of him. So I decide to see #8 (who is now number 7). She had fallen out of bed and broke her arm. Went in to check on her and guess what. She's taking a nap. So I'll just move her visit to Friday since she's 1x week anyway. My #9 was supposed to receive IV potassium and mag, however she is in the next city with her dad who is dying of lung cancer, so she decided to delay the medicine (this would be her first dose x 3 doses) until this is all done. Back to see my original #1. He's home, so I get to do his wound care. He has a traumatic wound on his leg I've been treating for a few months. It was sooooo sloooow to heal, and I had to recert him last week. It has shrunk down so much in the past week I think I may be able to discharge him in a week or two. Woot! So saw a total of six people today, finished visits by 3pm. Headed over to the satellite office we have up here so I don't have to drive back down to the main office, call and confirm my visits with my scheduler, and make a few phone calls. Had to clarify those follow up appts with the wound care center. Yes both patients were right. So guess who gets to write the new order and tell the scheduler two of her 3x week wound cares are now daily x 14 days? Yeah boy! Me! Notified the doctor's office of the lady with the dying dad that she will not get her medication until she gets back from that and we will delay the post med lab work until after the med is done. All in all was home around 415 today, had most of my charting done in the patients homes for a change so just need to document one or two items!

I use my own cell phone since I have unlimited. I don't volunteer my number but the patients will get it by caller ID or if they straight out ask. I don't answer my phone if they call after hours unless it's a special case. Like one time I had a patient on a pca pump and it started acting up so her husband called me at 9:00pm. I was able to talk him through fixing it and went out the next day. If he called the office he would have gotten the on call nurse who lived 45 minutes away and didn't know the pump she was on so she would have had to go out. Saved everyone time. They will still call your work phone at all hours. Just don't answer. They are all told to call the office number to get the on call nurse after hours.

Um why did they tell you to remove it? Basic nursing documentation includes quoting what the pt says if it is pertinent to the case. I believe you would be covered if you quoted what the patient said had happened then document you are unable to assess wound due to non-removable dressing in place dry and intact. then call the md to get/confirm orders.

It doesn't matter what that ft RN says. Pets are supposed to be restrained. Do I have my pts restrain theirs? Not always. Especially this collie one has he's cute haha! But if another nurse goes in and says what you said I would not give her a hard time about it. It should be company policy so she shouldn't be giving you a hard time.